[ÉCHINOPS Project: Collaborating with Law Enforcement to Help the Escapees of the Healthcare System].

Abstract

Objectives In Canada, it is estimated that 5 to 31% of police interventions involve people with mental health disorders. The objective of this review of the scientific literature is to raise a myriad of issues in the approach to these patients in the community. We then illustrate this context with a Montreal initiative: The ÉCHINOPS Project (Hybrid Community Team for Innovative Interventions NPO-Psychiatry-SPVM). Method A bibliographic search was carried out in June 2022 on Pubmed, EMBASE, PsycINFO and CINAHL, using MeSH words Police, Law Enforcement, Crisis Intervention, Mental Health Services, Mental Disorders, Mentally Ill Persons, Intersectoral Collaboration, Interprofessional Relations, Interdisciplinary Communication, Patient Care Team and about 40 different key words, leading us to more than 1100 articles, regardless of the time and language of publication. Two members of the research team read the titles and abstracts to retain about 100 articles. Snowball research of bibliographies eventually lead to a sample of about 110 articles. We used the software Zotero version 6.0.37 to manage the sample. They had to be published either in French or English. We then organized our data into sections to summarize the issues: Interactions Between Patients and Police Officers and Procedural Justice; Use of Force and Morbidity; Transport to a Hospital Center; Judicialization; Consultation and Resolution of Situations on Stage; Access to Mental Healthcare and Hospitalizations; Experiences and Satisfaction of Citizens and Beneficiaries; Experiences and Satisfaction of Healthcare Providers; Economic Aspects. Results Over the last 40 years, the deinstitutionalization of psychiatric services has led to an increase in contacts between mental health patients and law enforcement. While demonstrating a cultural change regarding the role of police officers in the general population, initiatives around the world highlight a need for additional training on mental illness and growing interdisciplinarity between police services and the healthcare system. This need requires the development of partnerships and new models of collaboration in the community. Conclusion Made up of mental health nurses and community psychiatrists, the ÉCHINOPS Project team works in collaboration with police forces to play a consulting role and to implement and consolidate mixed practices for people with mental health issues. The team's operation is inspired by the models of mixed intervention teams known as "Co-response" or "Street Triage" which have been the subject of several projects in Canada and other Western countries. A mixed intervention team has taken off as part of a pilot project in Montreal's East-end since January 2022.